reading-overview

Introduction

In recent years, the importance of reading instruction for children and adults with Down syndrome has been increasingly recognised. [1-11]

This review draws on research into the reading development of typically developing children and factors which influence their progress [17-23] A number of these studies indicate that reading ability is often a strength for children with Down syndrome and better than might be predicted on the basis of their language skills or general mental age measures.

A number of studies also indicate that literacy achievements have improved as the children’s educational opportunities have improved, and that children being educated in mainstream inclusive settings have higher levels of literacy skills than children of similar ability who are being educated in special education settings. [TODO: references 11]

The importance of reading

Reading is a fundamental life skill

Being able to read is a skill that most people take for granted and it is difficult for them to imagine what life is like for someone who cannot read. Print is all around us in our daily lives, from shop names, adverts on hoardings, street names, sign posts, departure boards in stations and airports to names and instructions on food packets, videotapes, games and equipment and names and addresses in telephone directories. We take for granted the ability to leave a note, write a card, write a shopping list, complete a form and look up TV programmes in the newspaper or magazine. Most of us also take for granted our ability to enjoy a novel or read a book for information. These different reading activities require different levels of reading ability.

A ‘reading age’ of eight to nine years, that is the average level of reading skill of a typical eight to nine year old, is adequate to read many daily newspapers and books and to write letters. While some individuals with Down syndrome may not achieve this level of reading, many will if they are given the opportunity to learn [TODO: references 10] If they only achieve a limited level of socially useful literacy, this will be a benefit. The only way to find out what level of literacy each child is able to achieve is to give him or her every opportunity to learn with well planned teaching activities from preschool years to adult life.

For children and adults whose literacy skills are limited it is still important to value them and make them functional, as Christopher Kliewer argues eloquently in an article entitled Citizenship in the literate community and in his book Schooling children with Down syndrome. [TODO: references 31] Kliewer describes teachers who made sensitive and intelligent use of the limited sight-word reading skills of some pupils with Down syndrome in their classrooms, while others dismissed this level of skill as ‘not real reading’.

Reading interacts with language and memory skills

Benefits of reading instruction

Acquiring reading and writing skills:

• for practical use
• for pleasure

Developing vocabulary and grammar knowledge

Developing spoken language skills

Developing working memory skills

Access to general knowledge and the school curriculum

Support for problem solving and thinking skills

While being able to read and to write is a practical skill to be used in all the ways described above, reading ability also influences the ongoing development of language and memory skills. Research on the links between typically developing children’s reading progress and other aspects of their cognitive development suggest reciprocal interactions in the following ways.

Children vary in their rates of developmental progress in their preschool years and when they start fulltime school, in any class of 30 five year olds, some children will have more language knowledge and better short-term memory skills than others. Research studies have shown that the more language knowledge and the better the phonological awareness (ability to identify the sounds that make up words) and working memory skills (short term visual and verbal memory spans) that children bring to the task of learning to read, the faster they will learn to read in the first year of reading instruction. In the second year in school, reading success appears to develop language, working memory and phonological awareness skills. [TODO: references 33] Over the second school year, children who have better reading skills show greater gains in language learning and in increased short-term memory spans than children who are not progressing so fast with reading. Progress in reading, speech and language, and memory are interlinked and can support each other in a reciprocal way.

Being able to read opens up access to books and knowledge from print via computer programmes and newspapers and the main vocabulary learning time for typically developing children is between the ages of about 7 and 16. It has been estimated that children come into school at about 5 years with vocabularies of some 2000 words but between 7 and 16 years they typically learning on average some 3000 new words every year. [TODO: references 35]

Margaret Farrell, an experienced Australian teacher [TODO: references 7] when children are denied access to typical reading instruction and inclusion in this primary curriculum.

Evidence of the same benefits for children with Down syndrome

Preschool children

See also:

• Reading and writing development for infants with Down syndrome (0-5 years)

Individual case studies from our work and others, also provide evidence of the beneficial effect of reading on speech and language skills. [2-4] For the young, preschool age children, case study records suggest that early reading activities from the age of 2 to 3 years encourage progress to longer utterances and improved grammar in speech. They also suggest that reading improves articulation and speech intelligibility. For most children with Down syndrome, there is a well-documented lag between language comprehension and expressive speech skills. This means that children with Down syndrome understand more than they can say, probably due to a variety of difficulties, which may include problems with word retrieval, sentence structuring and speech-motor control.

The limited development of working memory for children with Down syndrome [41-43].

A mother’s view of the benefits of early reading from a letter to the author

“I started to teach Emma to read after hearing you talk in Bristol seven years ago. She was then two years and four months of age. Emma is now nine years old and an able and avid reader. She attends our large, local, mainstream primary school and holds her own well in second year junior class. She seems to develop in leaps and bounds. Being able to read has done so much for her.

“It helped her speech. For example, when she began to read at age two, she spoke understandably but imperfectly as she left out definite and indefinite articles, prepositions, etc. The change came when she was able to sentence build in flashcards. Today her speech is mature and her teacher commented at the last parents evening that the extent of her vocabulary and her turn of phrase would leave many in the class standing.

“It helped in the way other children regarded Emma and not least her own self-esteem. They knew that in reading she was among the best in the class. This apparently less able child wasn’t so less able after all!

“Emma is now an independent reader and books give her so much. She wakes early and reads for at least one hour every morning. She makes her own choice of book but everything she reads fulfils her - she chuckles when she reads ‘The Twits’ and cries over ‘Heidi’. These are her two favourite books at the moment and she reads them over and over again. Equally she will read poems or her atlas, history book, nature book etc. from which she teaches herself. She loves her Bible. She is very proud when her five year old sister carries the newspaper to her and asks ‘’What time is…on television?’’ she is always able to tell her and I feel that Sarah, who I feel senses rather than knows of Emma’s differences, is thrilled with the sense of her big sister having the ‘big sister’ image for once.”

School children

Data from a small longitudinal study [TODO: references 15]. The gains in short-term auditory and visual memory spans also represent about a 2 year advantage as in typical development digit spans increase from 3 at about 5 years to 7 at about 15 years. The two groups had been at the same level on both language and memory measures 4 years earlier.

Table 1. Mean matrices, language and memory scores for readers and non-readers in 1991 and 1995 (raw scores) [TODO: references 15] Reproduced with permission

Key for Tables 1-4: BPVS (Vocabulary comprehension): British Picture Vocabulary Scale; TROG (Grammar comprehension): Test for Reception of Grammar; Matrices (Non-verbal reasoning ability) : Ravens’ coloured matrices |

Table 2. Age equivalent scores for 1995 BPVS and TROG measures for readers and non-readers [TODO: references 15] Reproduced with permission

This data was collected during a memory training study and the longitudinal data shown in [Table 3] indicates that the two groups benefited equally from the training, but for those not in reading instruction, the memory gains slowly disappeared. All but one of the readers were in mainstream classrooms, so part of the gains could also be due to a more stimulating language environment. However, when the researchers looked at the data collected at the start of the memory study from the large group of children who were in special schools (see [Table 4]), those who could score on the reading assessments show the same gains for language and memory despite being in poor spoken language environments (mainly in schools for children with significant learning difficulties).

Table 3. Mean auditory and visual memory scores for readers and non-readers (s.d.s in brackets) [TODO: references 15] Reproduced with permission

Table 4. Language and memory measures for special school readers and non-readers (raw scores) [TODO: references 15] Reproduced with permission

Teenagers

The hypothesis that print influences speech and language development is also supported by the results of work with adolescents with Down syndrome. [TODO: references 44]

Further data to support the view that being involved in reading and writing activities, even with maximum support from a classroom assistant, will improve the spoken language skills of young people with Down syndrome comes from a recently completed study by the author and colleagues. [TODO: references 16]

Table 5. Effect of school placement on language and reading achievements [TODO: references 16] Vineland Adaptive Behaviour Scale

[Table 5] shows that the teenagers in inclusive education placements were, on average, more than 2 years ahead of their peers of similar ability in special education in spoken language skills and more than 3 years ahead on reading and writing measures. While some of the spoken language gain could be the result of being in a more stimulating and normal spoken language environment, we believe that reading and writing on a daily basis has also been important. All the teenagers in inclusive placements have been full members of an age appropriate class, with a learning support assistant to help them to access the curriculum and to record their work in writing. Even the teenagers in the group who cannot score on a test of independent reading ability have had the benefit of being involved in reading instruction, phonics and spelling work, putting their ideas on paper and in reading aloud grammatically correct sentences when reading their work with support.

Measuring children’s progress and interpreting the data

• In this module there is a great deal of data illustrating children’s achievements in ‘age-equivalent’ scores.
• The reader should note that, while language scores of 6-7 years, or even 4-5 years, may seem rather a low achievement for children who may be teenagers, typically developing children are quite competent language users at 4-6 years.
• Reading and writing achievements of 8 years give children and adults independent reading and writing abilities.
• These scores are included to give parents and teachers a realistic view of children’s progress.
• IQ scores are reported in some studies to indicate that children categorised by IQ to have moderate (IQ below 70) to severe (IQ below 50 in the UK) learning difficulties can achieve useful levels of literacy skills.

The experience of reading

One of the major benefits of being able to read is being able to read stories, from children’s books to the masterpieces of literature. Stories of all sorts engage our imaginations and provide unlimited pleasure for most of us. If children cannot read well enough to read for pleasure they should still be able to enjoy involvement in stories by being read to, by being involved in plays and by being involved in story making and story telling with friends and groups in class, however delayed their development. This point has been well argued by Nicola Grove in a book entitled Literacy for All, which contains a wealth of ideas for involving all children in the world of stories, plays and poems including the great classics such as those by Shakespeare. [TODO: references 46]

Reading stories daily to children from infancy right through childhood will help them to learn to read. Children who are read to know that books are fun and full of entertainment as well as information. Children who are read to will have larger vocabularies as they will learn new words and concepts from books. Children who are read to will know that the words on the page have meaning and tell the story. One of the most important ways in which parents of children and teenagers with Down syndrome can help them to be ready to read, and interested in reading, is to read to them and talk to them about the stories they read.

One of the books that had an influence on the early work of the authors is called Cushla and her books [TODO: references 47] and it describes how the family of a seriously disabled child realised that she was able to read by the way she responded to being read to over a number of years. Cushla had learned the stories ‘by heart’ from the repetition of being read the same story over and over and went on from this ‘learning by rote’ to relate her learned stories to the printed texts and to become an independent reader. She was supported by a family who immersed her in the fun of stories. Note that they did not treat her early ‘rote’ skill as ‘not real reading’ but as the first step towards being a reader.

Summary

There is evidence to support the view that all children with Down syndrome will benefit from being fully involved in the pleasures of literacy and the imaginative world of stories, regardless of their independent reading abilities. There is also evidence to support the view that all children with Down syndrome should be in active and interesting literacy instruction from their pre-school years as it will help them to overcome some of their working memory and spoken language learning difficulties. This benefit will come from being supported in reading and writing, so that involvement in literacy should not be restricted to the independent readers and the value of supporting reading and writing on a daily basis for children who are not becoming independent readers should be recognised.

Learning to read

There is a large research literature on the development of reading skills in typically developing children, much of it consistent but there is still some argument about teaching methods [TODO: references 19]

There is a general consensus among reading researchers that early reading progresses by establishing two foundation processes, logographic and alphabetic, which lead on to an orthographic phase. [TODO: references 17]

Learning to read

Children learn to read by:

• Establishing a visual store of whole words (sight vocabulary)
• Looking for meaning in the text
• Learning the sounds that the printed letters represent (phonics)

The logographic and alphabetic skills are developing alongside each other over the first two years of reading instruction.

Logographic reading

Logographic reading is reading by sight, that is whole words are remembered by their visual pattern and a store of readily recognised sight words is established. This is how most beginning readers start and at this stage, before they have mastered the letter-sound links, typically developing children make both visual and semantic errors as they read. [TODO: references 53]

Visual errors occur when the word is confused with one that looks the same shape or has a letter or letters in common - as in reading ‘hair’ for ‘rain’, ‘gate’ for ‘gun’, or ‘this’ for ‘shoe’.

Semantic errors occur when the child reads a word that means the same or shares some meaning with the target word - as in reading ‘closed’ for ‘shut’, ‘go to bed’ for ‘sleep’, ‘bath’ for ‘flannel’ or ‘ship’ for ‘harbour’. Children with Down syndrome make the same errors as they begin to learn to read as typically developing children. In fact, these examples of visual and semantic reading errors are all real errors made by children with Down syndrome during early reading instruction in their preschool years (and some can be seen on the reading videotapes made by the Portsmouth researchers). They made these errors when reading single word lists, so they had no clues from storylines or pictures to help them. [TODO: references 1] Beginning readers only make semantic errors before they know phonics, i.e. the letter/sound correspondences. A child who knows the letter sounds would not read ‘bath’ for the printed word ‘flannel’, or ‘shut’ for ‘closed’, as they would know the initial sounds would be wrong for the printed words that they are trying to decode.

Establishing a sight vocabulary is an important early step as it gives the child a visual store of familiar words that they can use to help them to understand how letter-sounds and word patterns and pronunciations are linked. Research shows that good visual discrimination and visual memory skills lead to faster reading progress in the first year of instruction. [TODO: references 33]

!

Over a number of years, children build up this store of the visual patterns of printed words, and as adults, skilled readers read predominantly by sight, as words are recognised very quickly from their visual patterns after years of practice. The speed with which children learn to recognise words influences their reading progress. [TODO: references 20]

Alphabetic reading

Alphabetic reading is the ability to use phonic knowledge for decoding new words, i.e. by ‘sounding them out’. During their first year in reading instruction, children are learning a sight vocabulary and they are learning phonics. Research suggests that an understanding of letter-sound correspondences is more important for spelling than for reading in the early stages of learning to read and write. [TODO: references 17] Children learn more about the letters that make up words from trying to write words than from reading. Knowing letter sounds will only help children to guess unfamiliar printed words if they can ‘hear’ the separate sounds that make up spoken words, i.e. that cat can be split into 3 sounds, c-a-t. This skill is called phonological awareness. Not all typically developing children of average abilities can do this and poor phonological awareness skills are the most common cause of reading difficulties in typically developing children.

Using phonics to decode unfamiliar words is more difficult in English than in some other languages, as many English words are not pronounced with a regular link between letters and sounds. For example, save, gave, brave and have, or cough, through, bough, illustrate the difficulties facing children as they try to decode English in print. Island and yacht are more examples, and some words are pronounced differently depending on their meaning e.g. ‘she shed a tear’ or ‘she has a tear in her dress’. There is evidence that children learn to read more easily in languages where the print to sound correspondences are always regular.

However, children with good awareness of sounds and with good auditory memory skills do learn to read and write faster in English than children with poor skills in these areas. While children with poor awareness of sounds may be disadvantaged at first when they begin to learn to read, good teaching of phonics and spelling activities can teach children to be aware of the sounds in words and improve their phonological awareness. [TODO: references 21]

The final stage, reached later, Frith described as orthographic. Children now associate sound patterns with morphemes (regular units of sound larger than phonemes) such as ing, tion. Researchers have also drawn attention to the fact that many words can be divided into onset and rime, as in c/at, p/at or r/ing, str/ing, and that this may be the most useful level of analysis for children. Once they see the regularly spelled and pronounced units, they can read new words by analogy with ones they already know with the same letter groups in them. [TODO: references 23]

Language knowledge and reading comprehension

There is a third area of knowledge or skill that will influence reading progress and that is language knowledge. The more vocabulary and grammar knowledge that a child has the faster they will learn to read. Language knowledge will assist the child in guessing an unfamiliar word when reading a sentence, in one of two ways. If the child sounds out the letters of the word, they will only be able to guess the word if it is one already known in the spoken language of the child and it fits into the meaning of the sentence. Letter sound knowledge and context - understanding the meaning of the text - are often used together by a child to identify the word.

The purpose of reading is to understand or gain meaning from text, therefore there is little point in reading if you do not understand the text. Reading comprehension difficulties are quite common in the classroom and often linked to poor language knowledge and poor listening comprehension skills for age. [TODO: references 55] There is less agreement between researchers about the role working memory skills play in reading comprehension, but limited working memory capacity is likely to affect the ability to process text with meaning.

A number of studies have identified that children with speech and language impairments in relation to their non-verbal abilities have difficulty with literacy. [57-62] These children typically have poor working memory skills for age as well as speech and language delays.

Recent studies have also identified that children with limited working memory skills for their age, have difficulties with literacy and numeracy, in the classroom. [TODO: references 63]

Summary

Influences on reading development

• Experience with books - being read to
• Quality and quantity of instruction
• Amount of time spent reading and writing

Good visual and auditory memory skills and good language knowledge help the beginning reader. Over the first two years of reading instruction children build up a sight vocabulary and master the letter-sound correspondences to a stage when they can use them to decode an unfamiliar word and to begin to spell correctly. Once children begin in reading instruction, learning phonics will increase their awareness of sounds in words and their speech discrimination skills. They will also learn new vocabulary and grammar from reading. In other words, there are reciprocal relationships between spoken language, auditory and visual discrimination, memory skills and reading. Once the children start to read, reading activities develop these other cognitive skills.

Reading and literacy development for individuals with Down syndrome

Reading research is in its infancy

While there has been a steady increase in studies of reading development in children with Down syndrome over the past 15 years, there is still only limited information available to guide parents and teachers, as most studies describe the reading achievements of small groups, using limited measures and with little or no information on the type or intensity of reading instruction given to the children.

One reason for the limited amount of information available on the reading abilities of children with Down syndrome is that until recently it was assumed by most professionals that most of the children were not able to learn to read and consequently, the majority of teenagers and adults with Down syndrome alive in the world today have never had the opportunity to learn to read. Parents have been fighting this view for many years and publishing reports of the literacy achievements of individuals. [TODO: references 40] conducted a survey of 160 parents of children with Down syndrome in the UK in 1976 and reported that many of these young people had been taught to read and write to a useful level by their parents, usually with opposition from professionals. The case studies presented by the author and her colleagues in their publications before 1995 were also reports of children who had been taught to read by their parents, with support from the research team.

Professionals in the USA, Australia and the UK working in experimental intervention and education programmes have been aware of the potential for literacy development for children with Down syndrome for at least twenty five years [TODO: references 1] but the special education facilities available to most children have been slow to introduce effective literacy teaching into the curriculum.

At the present time most studies simply describe the reading achievements of rather small groups of children and young people [TODO: references 29] are beginning to appear.

Reading is a skill that needs to be taught and until all children with Down syndrome have access to appropriate literacy teaching, from preschool and primary years, it is not possible to determine what proportion of the population can achieve a functional level of literacy nor the range of achievement that may be possible.

In the UK and in most countries until recently, the majority of children with Down syndrome have been educated in special schools for children with significant learning difficulties. In these schools literacy teaching was usually limited to teaching a social sight vocabulary to teenagers; that is, a sight vocabulary of the words that may be useful in getting about their environment such as ‘ladies’, ‘gents’, ‘exit’, ‘bus stop’, ‘police’. Introducing literacy teaching at the usual age in the UK of five years was not considered appropriate for children with Down syndrome.

Fortunately this situation is changing rapidly in the UK and in many other countries. In the UK over the past ten years, increasing numbers of children with Down syndrome are being included in mainstream education. Between 70% and 80% now start school in the same neighbourhood primary schools as the typically developing children in their community from five years of age, with appropriate additional support, and having the same access to literacy teaching from five years of age as all other children. [TODO: references 73] involving 45 children with Down syndrome, age range 7 to 17 years, all in mainstream education. This study is following the children’s progress with a variety of reading and phonological skills measures. It is also comparing the effectiveness of different teaching strategies on the children’s progress, one of which has an emphasis on phonological skills training. This study should provide very useful information for teachers and parents.

However a review of the existing data may give some indications to guide educators and serve as a baseline against which future achievements can be compared.

Levels of achievement

Individual case studies

The functional literacy skills of individual children with Down syndrome were being reported as early as 1961 by Butterfield [TODO: references 75] The foreword to this book, written by Nigel’s father, describes the difficulties he experienced when trying to convince the educators of the time that Nigel could actually read and write!

It was the progress of Sarah Duffen as described by her father Leslie [TODO: references 40] to begin research in this area in 1981.

Since 1981, they have been exploring this approach and have accumulated a number of case studies of which the following are examples of early readers who continued to have good teaching.

Early readers

! Daniel’s work - age 9 years

Figure 1. Daniel’s work - age 9 years

Daniel was introduced to reading at 2 years and 4 months when he had a production vocabulary of about 50 single words. He learned to read 10 words in two months and these were chosen to build two word phrases for him to read at 2 years 8 months. These were rapidly transferred to his speech, according to the observations recorded by his home visiting teacher (Norris, 1989). By 2 years 11 months Daniel was reading six 3-word phrases, which again he rapidly began to use in his speech. At 3 years 4 months he could read 66 flashcards and many 2 and 3 word combinations of these. The next month he was reading simple books and the words ‘and’ and ‘a’ appeared in his speech. At 3 years 6 months he was reading 4 word sentences and at 3 years 8 months he could read 116 words and was speaking in 6 word sentences. Daniel’s rapid progress continued and, at 8 years of age, his reading age was 12 years 4 months and spelling age 9 years 9 months on the school assessment. An example of Daniel’s free writing at age 9 years is shown in [Figure 1].

Daniel finds handwriting difficult and is still printing. He prefers to use a word-processor for writing and wrote the above story on his computer. He reads punctuation correctly but leaves much of it out when writing. He is being educated in a mainstream school and is average in his class for all subjects.

Joni was introduced to reading at 2 years of age, She has been educated in a mainstream school and has excellent support from her family and from her learning support assistant through school. At ten years of age, Joni has a reading age (BAS) of 10 years 10 months, a spelling age (BAS) of 9 years 5 months and reading comprehension age of 7 years 3 months. Her vocabulary comprehension (BPVS) was 6 years 3 months and her grammar comprehension (TROG) was 6 years 8 months. Her free writing is shown in [Figure 2].

! Joni’s work - age 10 years

Figure 2. Joni’s work - age 10 years

Louise was introduced to reading at 3 years 2 months when she learned to read her family names, ‘Mummy’, ‘Daddy’, ‘Stephen’ and ‘Louise’ by playing matching games. Two months later, she learned ‘car’, ‘book’, ‘shoe’, ‘teddy’, ‘ball’ and ‘dolly’. At 3 years 7 months ‘walking’, ‘sleeping’ and ‘drinking’ were added and she read two word phrases such as ‘Louise walking’, ‘Mummy sleeping’. Louise’s mother and speech and language therapist worked together, making simple books and a dictionary of pictures into which Louise had to slot the words into the right pages. At 4 years 4 months she could read 35 single words on flashcards and some two word sentences. She could also pick out known words in storybooks. Two months later, she could read more than 60 words and short phrases, in games, in full sentences and in books. She was also able to memorise and say whole sentences that she had previously read. At 8 years 8 months, Louise had a reading accuracy age of 7 years 4 months and reading comprehension age of 6 years 8 months on the Neale Analysis of Reading Ability. She was progressing well with both reading and writing, forming capitals as well as lower case letters in joined handwriting.

Alistair learned to read in the same way as Daniel, Joni and Louise. At 10 years 8 months he had a reading accuracy age of 7 years 11 months and comprehension age of 6 years 9 months on the Neale. An example of Alistair’s writing is shown in [Figure 3].

! Alistair’s work - age 10 years

Figure 3. Alistair’s work - age 10 years

Writing and spelling progress shows considerable variation among the children. In the UK the children begin to have spellings to learn and spelling tests from their first year in school at age 5 years. Our observations indicate that early on the children are ‘visual’ spellers. For example, one pupil’s teacher reports that at 6 years she writes the word, looks at it to see if it looks right and if not corrects it. At 7 years, Daniel was still a ‘visual’ speller but at 9 years is reported to be a ‘phonic’ speller by his teacher.

Data by Byrne [presented later in this module], indicates that spelling abilities are usually close to word reading abilities for many children with Down syndrome, but that reading with comprehension is delayed relative to reading age. This issue will be discussed fully later.

While case studies such as these are valuable, it is not possible to predict from them to the potential for literacy for all children with Down syndrome. The children described have benefited from early intervention at home, continuous teaching from their parents and mainstream schooling. However, recent research from Australia [TODO: references 11] indicates that at least 60-70% of adults can reach 8-9 year levels with appropriate teaching.

The Portsmouth researchers report that they have worked with other children who made the same pre-school progress but who received no further literacy teaching in their special schools so can read no more as teenagers than they could as 5 year olds. [TODO: references 4] More examples of children’s work can be seen later in this module.

Early reading and later achievements - a letter from a mother, November 2000

I thought you might like to hear some great news about my son whom you encouraged to read back in 1986. Francis was born in October 1983 so he turned 17 some weeks ago - and the good news is that he passed 6 GCSEs in the summer!!

They are English - G - but no one expected him to get that one - French, music, and 2 sciences at E and history D. He has been at Heathfield Community College and is a great credit to them. But I also want to thank you because I truly believe that his early start in reading, and the confidence it gave him, have been of material help. And your encouragement and the discipline of recording his progress at age 2-3 absolutely kept me going. We then lived in County Mayo, Ireland. So - from the bottom of my heart - THANK YOU!

Group studies

Two studies published in the UK in the 1980’s indicate reading progress in the first years at school. Casey and colleagues [TODO: references 28] followed the progress of 36 children with Down syndrome, chronological age 3 years 8 months to 10 years, mental age 2 years 3 months to 6 years 8 months; 18 were in mainstream placements and 18 in schools for children with moderate learning difficulties. The children did not differ in cognitive development at the start of their schooling. After two years, 89% of the girls and 67% of the boys in the mainstream classrooms could achieve above baseline scores on both the accuracy and the comprehension components of the Neale Analysis of Reading Ability. The children in the special schools were lagging behind with 89% of the girls and 33% of the boys scoring on accuracy and only 44% of the girls and 33% of the boys scoring on comprehension. As the children were equally able at the start of the study, it is likely that the difference in reading progress two years later is due to differences in the teaching of reading in the two school types.

In a study of 58 children with Down syndrome in Manchester, Lorenz and colleagues [TODO: references 29]

Follow up studies

Studies from Australia and New Zealand report on small samples of children followed up from early intervention programmes. For a group of 8 children with Down syndrome (CA 7 years 2 months to 9 years 3 months), (IQ 48 to 67), reading ages of 6 years 1 month to 9 years 3 months are reported. [TODO: references 27]

Some of the children from this early intervention group are included in a study of the literacy skills of 30 Australian adults published in 2001. [TODO: references 11]

Measuring children’s progress and interpreting the data

• In this module there is a great deal of data illustrating children’s achievements in ‘age-equivalent’ scores.
• The reader should note that, while language scores of 6-7 years, or even 4-5 years, may seem rather a low achievement for children who may be teenagers, typically developing children are quite competent language users at 4-6 years.
• Reading and writing achievements of 8 years give children and adults independent reading and writing abilities.
• These scores are included to give parents and teachers a realistic view of children’s progress.
• IQ scores are reported in some studies to indicate that children categorised by IQ to have moderate (IQ below 70) to severe (IQ below 50 in the UK) learning difficulties can achieve useful levels of literacy skills.

Only 4 of the 30 adults could not attempt the text reading task. The average language comprehension score for the group on a vocabulary test was 7:2, with 2 very high scorers achieving scores of 17:8 and 16:6. The best readers had the best language scores and the individuals who had been introduced to reading in preschool had the highest reading scores as adults. The authors note that the whole group showed interest in reading and drawing activities in their leisure time. Two of the group had been actors in a TV series and had learned their scripts, with reading and language ages between 8 and 10 years.

Irwin [TODO: references 26] was 52.56 months with scores ranging from 33-79.

Surveys of achievements

In a survey of 90 teenagers in the UK in 1987, [TODO: references 77] reporting on a group of forty-three 16 year olds in 1982, state that seven could read quite well, about the same proportion of the group as that in the 1987 study.

In a survey of 33 young adults with Down syndrome in the USA aged 17 to 25 years, Fowler, [TODO: references 13] reports reading ages of 5 years 7 months to 16 years for word attack skills, 6 years 7 months to 12 years 7 months for word identification and 5 years 6 months to 8 years 4 months for reading comprehension. These young people had mental ages of 5 years to 7 years 1 month, vocabulary ages of 6 years 1 month to 11 years 1 month and grammar ages of 5 years 1 month to 7 years 8 months. The reader will note that reading comprehension is close to grammar comprehension and word reading close to vocabulary age. Reading performances all range above that which might be predicted from mental age measures.

The reader is reminded that the data from all these studies and surveys is difficult to interpret as many of the children studied will not have been taught to read. We certainly cannot assume that all the children and young people had reached the upper limit of their reading ability. All the studies have very small sample sizes and it is not clear how representative the children are of the whole population of children with Down syndrome. Intervention studies have often involved children of parents with higher than average educational levels. None of the published studies provide any information at all about the methods or intensity of reading instruction except some of the individual case studies.

Current research in the UK

Some studies of larger and more representative samples of children with Down syndrome in mainstream education are now underway in the UK.

In one longitudinal study, the Portsmouth research team have followed the progress of 24 children with Down syndrome (10 girls and 14 boys, CA 4 years 11 months to 12 years 7 months, mean 8 years 2 months) and compared their progress with a group of their mainstream classmates who are matched with them on reading age (and are therefore slow readers for age), as well as a group of classmates who are average readers for their age. [TODO: references 3] The study has charted the reading, writing and spelling progress of the children, looking at the cognitive strategies they are using to read and the links between reading, language and memory skills. These children are fully included in the classroom and receive similar literacy teaching to their peers, with the support of a Teaching Assistant.

At the start of the study, [Table 6] shows that all the children with Down syndrome were learning to read and their reading ages range from 5 years to 8 years 5 months for word reading, 6 to 7 years for comprehension and 6 years to 7 years 2 months for spelling. Vocabulary ages range from 3 years 7 months to 5 years 4 months, and grammar ages from 4 to 5 years. The children with Down syndrome have reading ages higher than their language comprehension ages would predict.

Table 6. The cognitive profiles of the three groups of children at the start of the study (Age related scores years.months) [TODO: references 25] Reproduced with permission

The typically developing children identified by their teachers as average readers for their age demonstrate even and age appropriate cognitive profiles over all the measures, whereas the slower readers for their age in the same classes (matched for word reading ability to the children with Down syndrome) turn out to be significantly delayed relative to the average readers on all the language and cognitive measures. The children with Down syndrome, while matched with the slower readers on the reading measures, are significantly behind them on the number, language and memory measures. In other words, the children with Down syndrome show advanced reading ability compared to all their other cognitive skills at this time.

Test for reading strategies

• Content words: toy, book, play, shoe, house, yellow
• Function words: my, you, saw, each, very, next
• Non-words: rog, fem, vig, mip, ped, bup, fum

By phase 3 of this study, two years after the first assessments, the children with Down syndrome are still not significantly behind the slow readers on word reading but they are on spelling and reading comprehension (see [Figure 4]

! Progress in word reading

Figure 4. Progress in word reading (BAS Reading) [TODO: references 79]

! Ability to read words and non-words (alphabetic skill)

Figure 5. Ability to read words and non-words (alphabetic skill) [TODO: references 79]

However, at this point, 7 of the children with Down syndrome have alphabetic skills, i.e. they can read some non-words correctly, demonstrating the ability to use their phonic knowledge (see [Figure 6]

! Relationships between reading, language and number skills.

Figure 6. Relationships between reading, language and number skills.

After 4 years from the start of this study, 17 children with Down syndrome, still in mainstream schools and in the research area, were followed up. [Table 7]. Their word reading ages range from 5 years 5 months to 9 years, mean 7 years 2 months, spelling ages range from 6 years 1 month to 9 years 11 months, mean 7 years 4 months, reading comprehension ages range from 6 years to 7 years 6 months, mean 6 years 1 month, vocabulary ages range from 3 years 2 months to 12 years 2 months, mean 6 years and grammar ages range from 4 years to 5 years 9 months, mean 5 years. Nine of these children had reading ages over 7 years 4 months and 8 of the 9 had spelling ages over 7 years, with reading comprehension for the 9 ranging from 6 to 7½ years.

Table 7. Individual profiles for children with Down syndrome (Year 5 of study)

All of the 17 children could score on standardized word reading tests, 16 could score on spelling and 14 on reading comprehension. If this data is compared to the studies carried out in the UK with earlier cohorts of children [TODO: references 28] then this Hampshire group are clearly achieving much higher rates of literacy acquisition than the cohorts of the 1980s or before. These children have many more years of education in school and further education ahead of them. Half of them are showing independent reading skills at a level to give them functional literacy as adults and it is likely that 60-70% will reach this level by adult life.

Two conclusions may be drawn at this time. Some children with Down syndrome will achieve functional levels of literacy (8 years and above), others will achieve a level of literacy skill which will allow them to record work in the classroom and to read with assistance. Some may not achieve any useful level of literacy skills. At present the research groups are so small and access to good literacy teaching still not available to all children in the UK. Accurate estimates of what might be expected still need to be documented by studying much larger samples of children.

The effects of an early start

Early reading

See also:

• Speech and language development for individuals with Down syndrome - An overview

The issue of early ‘sight word’ reading, beginning in the preschool years, discussed in the individual case studies, needs further consideration. Some of the early readers with Down syndrome find ‘sight word’ learning very easy and it appears to have very positive effects on the development of their spoken language skills and general cognitive development. Buckley [TODO: references 1] identifies the need for further research here as critical period issues for language learning may be relevant, especially for establishing the use of grammar and phonology in spoken language.

Recent work shows that preschool children with Down syndrome are able to learn sight words just as fast as age matched typical preschoolers. Appleton [TODO: references 86]

! Preschool readers - progress at 6 years

Figure 7. Preschool readers - progress at 6 years

This data supports the view that reading ability is a significant strength for children with Down syndrome and that, for many, the visual discrimination and visual memory skills needed to learn sight words are not delayed for their age. At the stage when all children’s reading progress is largely supported by logographic skills (sight word reading), the readers with Down syndrome (61% of the group) are keeping up with their peers on reading and on reading comprehension. Their progress supports the evidence that visual processing and visual memory skills are less impaired than other areas of their cognitive skills and should definitely be used to support all learning.

Summary

A number of conclusions may be drawn at this time from the published research studies and surveys of achievements.

See also:

• Reading and writing development for infants with Down syndrome (0-5 years)

• Some individuals with Down syndrome will achieve functional levels of literacy (8 years and above), others will achieve a level of literacy skill which will allow them to record work in the classroom and to read with assistance. Some may only achieve a limited level of literacy skills, perhaps a sight word vocabulary useful in their daily lives, but this should be valued. At present the research groups are so small and access to good literacy teaching still not available to all children with Down syndrome. Accurate estimates of what might be expected still need to be documented by studying much larger samples of children and linking assessments of their progress with the quality and quantity of teaching available to them.

• Word reading is a relative strength and spelling abilities seem to develop well over time and to be close to word reading abilities. Reading comprehension levels are often significantly behind reading and spelling levels but at a level or ahead of language comprehension levels for individual readers. Reading comprehension abilities have not been studied systematically and research in this area is needed.

• Reading comprehension will be affected by vocabulary knowledge, grammatical knowledge and life experience, working memory skills and word recognition skills - as they are for all readers.

• Phonic skills develop steadily alongside reading progress for many children and, while early reading skills are logographic and built on the visual learning strengths of children with Down syndrome, they show the ability to move on to be alphabetic readers when they reach about the same reading skill levels as typically developing children i.e. word reading at about 7 to 8 years.

• Handwriting skills have not been systematically studied but the examples of children’s work displayed in this module show that many children with Down syndrome can write legibly and develop adequate handwriting.

• Writing text, i.e. putting thoughts and words on to paper, is a skill that varies widely according to the author’s experience and the case examples included in this module illustrate this range. Some children of ten years are writing their own stories but many will be needing support to write their ideas down, even when they are quite good readers. Reading with comprehension and writing ideas and information down are linked skills and helping children to make books and to write about life events and school curriculum projects i.e. to write about experiences that they have had, will help both creative writing and reading comprehension abilities.

• The information and examples reviewed demonstrate that reading abilities are definitely a strength for children and adults with Down syndrome and often their achievements are significantly better than might be expected given the extent of their general learning difficulties (IQ levels) and their speech, language, working memory and motor skill delays.

• Word reading abilities are a strength from preschool years and many children with Down syndrome show the same ability to learn sight words as typically developing preschoolers. Readers with Down syndrome can keep up with typically developing readers in the early years of education.

• Word reading abilities are demonstrated by many children with Down syndrome from as early as 2 years of age and children who are introduced to reading in preschool years attain the highest levels of literacy later. Reading activities from this age can be deliberately used to teach spoken language and there is some evidence to show that reading instruction teaches new vocabulary and grammar, increases world knowledge, improves working memory development and improves speech clarity for children with Down syndrome. The use of even a small sight vocabulary and reading activities specifically targeted at a child’s language comprehension level can produce some of these benefits.

• Students with Down syndrome can learn to read and to develop their reading skills in teenage and early adult years, and should have access to continued, skilled, literacy teaching.

Implications for teaching strategies

Teaching approaches

In addressing the question of teaching methods, the main issue is whether there are any differences in the way one should teach a child with Down syndrome to read compared with the teaching methods used for typically developing children. There is no published research which evaluates teaching methods for children with Down syndrome, though one study is underway at the University of York, UK. [TODO: references 74] However, the experience of the Portsmouth psychologists, who have been supporting the education of children with Down syndrome in mainstream classes for some 13 years, suggests that the same methods should be used for all children, but teachers will need to take account of the relative delay in language knowledge and memory skills of the children with Down syndrome when teaching them to read. The children will have smaller vocabularies and limited grammar, and with hearing difficulties and speech production difficulties they do not start school well prepared to master phonics. However, reading instruction and phonic instruction will help to improve their sound discrimination skills and speech clarity.

In the Portsmouth area and across the country, the Portsmouth research team provides training for teachers and support children in mainstream schools. In their experience, the approaches recommended in the UK National Literacy Strategy are appropriate for children with Down syndrome. They may be working at an earlier or differentiated level in each area of activity, supported by a Teaching Assistant, but they need the same range of activities. Therefore, with appropriate planning, they can and should be included in the Literacy hour.

The principles set out below apply to students of all ages, including those who are beginning reading instruction in their teenage or young adult years. For this reason, students are referred to rather than children.

!

Quality and quantity of reading instruction

Reading instruction needs to be fun - to build on the students’ enjoyment of stories and their experience of text in their environments. Reading instruction should also demonstrate the benefits of being able to record ideas and information right from the start. One of the benefits of learning a sight vocabulary on cards is that students can be helped to build sentences and create messages, before they can write, spell or decode. Computer software can also help them to do this. The aim is to show students why they want to learn to read.

It is important that the first message that students receive about reading from these activities is that we read for meaning i.e. that there is a message in the text. Reading is a language activity, it is a written form of spoken language and language ability will influence students’ ability to obtain meaning from text. Activities which help all students to look for meaning in text - to find the key words that convey meaning and to use the picture to help themselves - should be a priority. Work on creating texts together and then reading them is fun and will support reading comprehension skills, i.e. reading for meaning. Teaching and learning should be an interactive process with teacher or assistant working together to create and read text. Books on favourite activities or interests and individual diaries can be fun, and can be shared with friends and families. For both young and older students, photographs can make a good starting point for making text together.

Establish a sight vocabulary

!

While engaged in making books together, beginning readers of all ages will begin to establish a sight vocabulary of useful words for making sentences and words that are important to them like their own name and family names. The author and colleagues recommend teaching all students by establishing a small sight vocabulary first, choosing words and sentences that the children use everyday in their speech and encouraging them to build their own phrases and sentences with this sight vocabulary. This builds their confidence and enables them to learn that we read for meaning. The larger a student’s sight vocabulary, the larger the database that they can draw on to begin to understand how letters or groups of letters in these words represent sound.

Learning to understand and to use phonics is difficult for many students and typically takes children several years to master to a stage where they can attempt to spell and decode words independently (7 to 8 years). Although learning phonics is important, it should not distract from the engaging in the fun of being able to enjoy text and create messages using a ‘sight’ vocabulary with adult support. In addition, the more a student reads, the greater their opportunity to learn to understand the reading process and to establish a well-learned sight vocabulary. (Unfortunately, students who are slow to learn to read often have very limited experience of reading as a consequence, whereas students who are quick to learn do a lot of reading and so have increased opportunities to learn compared to the slower learner).

See also:

• Reading and writing development for children with Down syndrome (5-11 years)

Learning phonics

Learning about sounds in words can also be developed in fun ways, starting with singing rhymes for younger students and drawing their attention to the rhyming words, including showing them how they are written. Giving students the texts for songs that they know ‘by heart’ from singing them, can be an effective way for them to succeed in linking words to text as well as seeing the sound to letter correspondences. Games which ask students to find something in the room which starts with a particular sound can be another fun way to learn about sounds. This game is often called ‘I Spy’ and each player says ‘’I spy with my little eye something beginning with p’’ - (use sound for letter rather than name) - and the student who is first to find the answer takes the next turn. Read books that make use of rhyme, and write out a list of the rhyming words. Rhyme books may be more difficult to find for older students but a fun activity could be to write rhyming ‘poems’ together. These are just some ideas to make learning about sounds in words fun.

!

Words in students’ sight vocabularies that begin with the same sound can be put together to illustrate initial letter-sounds. As the student can already say these words when they see them, they can form the link for themselves between print and pronunciation begin to see how the letter-sound knowledge can help them to read an unfamiliar word.

In the classroom, use small sets of rhyming words and draw the students’ attention to onset and rime e.g m/at, h/at, p/at, c/at, f/at, and later s/ee, b/ee, tr/ee, kn/ee.

In phonological awareness training and assessments, students are asked to demonstrate:

• Rhyming awareness - which words rhyme or which is the odd one out
• Awareness of onset and rime - splitting word into initial sound and remainder
• Alliteration awareness - which words start with the same sound or which does not
• Phoneme blending - putting sounds together to make a word
• Phoneme segmentation - splitting a word into its sounds
• Phoneme deletion - what is the word left if a sound is taken away

There is very little research into the development of phonological awareness in children with Down syndrome though there is evidence that their abilities in this area are linked to reading progress, as they are for all children. [TODO: references 88] Their speech errors may result from poor and incomplete phonological representation of spoken words, rather than motor difficulties and therefore they do not have adequate sound representations of words to be able to link them to phonemes.

See also:

• Memory development for individuals with Down syndrome

One could speculate that this is also the case for most children with Down syndrome when they start school, as a result of poor phonological loop functioning in working memory. [TODO: references 42] However, the experience of learning about sounds and seeing them represented visually may well help the children to improve their stored information of the sounds and then to speak more clearly. Just practice of saying sounds and words may also have positive benefits for speech clarity.

Writing, creating texts and reading with understanding

See also:

• Reading and writing for teenagers with Down syndrome (11-16)
• Accessing the curriculum - strategies for differentiation for pupils with Down syndrome

Many students with Down syndrome find reading with comprehension difficult and it is very important to help them to make meaningful text to read back from the start of reading instruction. Learning to put thoughts onto paper and to read back with comprehension can be usefully linked.

The individually created books already mentioned make a good starting point built around photographs of activities or cuttings of the favourite football team or pop group. However, many aspects of the daily school curriculum provide opportunities to record information with support and to support comprehension of texts. The examples in [Figure 8], [Figure 9] and [Figure 10] show work that has been supported in a variety of ways for primary and secondary school pupils.

These pupils have Teaching Assistants to provide one-to-one support for at least part of the school day. The Teaching Assistants are encouraged to keep the student fully involved in thinking about what they want to write and creating the text for themselves, though they may need help to form sentences.

! Using a storyboard to support writing - age 12 years

Figure 8. Using a storyboard to support writing - age 12 years

! Support for reading comprehension work - age 7 years

Figure 9. Support for reading comprehension work - age 7 years

! Supported writing - age 13 years

Figure 10. Supported writing - age 13 years

Handwriting

The examples included in this module show a range of handwriting skills and illustrate that many children and teenagers are developing legible handwriting.

The Portsmouth psychologists encourage children to write from the start of reading instruction, tracing over words and sentences with fingers and pens, then moving on to copying and free writing. They have two reasons for doing this, firstly to develop the children’s motor skills and fine-motor control and, secondly, because research indicates that it is through early writing rather than early reading that children learn about letters in words. [TODO: references 17] shows that he had difficulty copying at that time but within 2 years he had legible hand writing. He was helped by activities to develop his spatial awareness and gross motor skills as well as his fine motor skills with the support of a specialist teacher and occupational therapist.

! Philip’s work - age 7 years

Figure 11. Philip’s work - age 7 years

! Philip’s work - age 9 year

Figure 12. Philip’s work - age 9 years

! Philip’s work - age 11 years

Figure 13. Philip’s work - age 11 years

Use of computers

See also:

• Utilising IT to assist the education of individuals with Down syndrome

Research indicates that children with Down syndrome are ‘visual learners’, that is, they learn more easily from visually presented than spoken information. The computer is therefore an ideal teaching aid to use to build on their strengths. Most young children with Down syndrome enjoy using computers and readily master the necessary skills to use the multi-media PC with mouse and keyboard. The range of software designed to teach all basic skills (including literacy and numeracy) to children with special educational needs is growing all the time. Many programmes designed for use with all children are also suitable. Meyers, [TODO: references 82] Many children with Down syndrome enjoy using the computer to write, using software that will help them to construct text and to spell, with picture and symbol support.

In summary

The research-based evidence available on the reading development of individuals with Down syndrome is limited. However there is evidence to indicate that many children with Down syndrome (some 60 to 70%) are able to achieve a useful level of literacy ability if given effective instruction and that all the children should have an opportunity to learn to read, as even a small sight vocabulary will help their speech and language skills and may improve their auditory discrimination and working memory function. Reading instruction should be provided at the same age and in the same way as for all other children. There is also evidence to suggest that reading should be considered as soon as the child has single word comprehension as the earlier the child is able to establish a sight vocabulary, the greater the benefit for their language and cognitive development.

However, there has been no actual research into effective teaching strategies and the above conclusions are based on teachers’ and researchers’ experience of monitoring children’s progress. It is clear from the limited literature available that while sight word reading is often a strength, reading comprehension at sentence and text level is more of a challenge for many children with Down syndrome and more research on how to develop reading comprehension is needed.

The evidence also indicates a wide range of individual differences for this group of children and this presents a problem for the teacher of an individual child with Down syndrome. It is not possible to provide guidance on the expected levels of achievement for individual children at the present time. A large longitudinal study is needed to provide this information.

For children and adults with Down syndrome, the benefits of learning to read may go beyond simply acquiring a functionally useful level of reading and writing skill. Progress in reading can develop speech and language skills, auditory perceptual skills and working memory function; all areas where individuals with Down syndrome usually display difficulties. [TODO: references 84] This is probably also true for many other children with moderate to severe learning difficulties.

Children with Down syndrome seem to often be good ‘visual’ readers, finding it relatively easy to establish a sight vocabulary from as early as two years of age. Children with Down syndrome will usually have considerably less language knowledge than other children at their reading level, so be less able to use context and phonological recoding strategies to access words and meaning. Further, to be good at phonological recoding, a child must be able to hear all the sounds in the words and given the hearing loss and auditory processing problems that the children often have, they are likely to be less able to use this route with ease than their typically developing peers.

Our observations however, suggest that despite these very real additional difficulties experienced by the child with Down syndrome compared to typically developing children, many do progress to being able to use phonological recoding for reading and spelling and they are able to use context. For the teacher, it is essential that they understand the level of skills that the child brings to the task and that they help the child to progress slowly but steadily. It is particularly important that teachers know how much language knowledge a child has in order to avoid exposing the child to material that they can read aloud but cannot decode for meaning. Further, all children learn new language from reading [TODO: references 18] so it is very important that the teacher appreciates that reading can be a powerful way to help the child expand their language knowledge.

Students with Down syndrome can continue to develop their reading skills into adult life, and should have the opportunity to continue to receive good literacy instruction in secondary and further education. [TODO: references 10]

Acknowledgements

The author would like to thank all the children, parents and teachers who have shared their learning, experience and skills with me over many years - and in particular Sarah, Leslie and Dilys Duffen, without whom the work would never have begun. Their continued interest, insights and support since 1979 have been invaluable.

Equally important to her understanding of the issues have been the contributions of all the author’s research students and colleagues; Elizabeth Wood, Ben Sacks, John McDonald, Gillian Bird, Angela Byrne, Glynis Laws, and Michele Appleton. However, the opinions expressed in the text, and any errors, remain the sole responsibility of the author. In the early days of the reading research from 1980, the wisdom and support of John Dennis, then Head of Psychology at the University of Portsmouth, allowed the work to develop.

Terminology

The term ‘learning difficulty’ is used throughout this module as it is the term currently in common use in the United Kingdom. The terms ‘mental retardation’, ‘intellectual impairment’, and ‘developmental disability’ are equivalent terms, used in other parts of the world.

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